94 studies, 65,608 people, 22 countries. And one figure that sums up years of research: nearly two in three transgender or gender-diverse people have experienced physical or sexual violence at some point in their lives. The first global meta-analysis on the problem, coordinated by the Johns Hopkins Bloomberg School of Public Health with support from the World Health Organization, is published in JAMA Network Open.
The first global map of violence against transgender people
The Johns Hopkins and Duke University team searched nine databases —PubMed, Embase, CINAHL, Cochrane Central, LILACS, PsycINFO, grey literature and conference proceedings— for studies published between January 2010 and January 2023, with no language or regional restrictions. After screening almost 30,000 references, they kept 94 unique studies, published across 137 articles and covering 65,608 adult participants from 22 countries.
The sample reflects the reality of the population studied: 46% were transgender women (30,435 people), 25% transgender men (16,580), 23% non-binary people (14,962) and 6% transgender people whose identity was not specified (3,630). Almost all the studies included trans women; slightly more than half included trans men.
The figures: two in three people, at some point in their lives
The pooled lifetime prevalence of physical or sexual violence was 64.23% (95% confidence interval: 47.38-78.17%), calculated from nine studies. Separately, slightly more than a third of transgender or gender-diverse people reported physical violence at some point in their lives (35.89%; 45 studies) and a third reported sexual violence (32.70%; 40 studies and 16,385 participants). Recent violence (past 12 months) stood at 21.63% for physical violence and 15.15% for sexual violence.
The authors could not pool psychological violence —insults, harassment, coercive control— because each study measures it very differently, and they present those estimates separately.
In low- and middle-income countries, sexual violence soars
One of the sharpest contrasts appears when the results are split by income level: in low- and middle-income countries, lifetime prevalence of sexual violence reached 68.32% (five studies), more than double the global estimate of 32.70%. Violence against transgender people is not spread evenly across the map.
Who commits the violence
The most frequently cited perpetrators were partners, family members, strangers, the police and people in detention. Four per cent of participants reported violence by healthcare professionals; in one Brazilian study that figure reached 33%. Differences between trans women, trans men and non-binary people were not statistically significant, and violence motivated by gender identity showed a prevalence similar to that of any other motivation.
Why this figure matters
Violence is a first-order determinant of health. It is linked to so-called minority stress —the sustained exposure to discrimination, harassment and assault— and to worse mental health, higher suicide risk and poorer outcomes in chronic disease, a link other studies covered on this blog have already documented, such as the Swedish mortality registry or the meta-analyses on suicide among transgender youth.
The WHO commissioned this review as a basis for designing evidence-based prevention and response strategies. The authors point to the limitations: most studies rely on non-random sampling, come from the United States and other high-income countries, and are based on self-reported accounts, with very high heterogeneity between studies (I² values above 97%). The global figures are therefore a solid guide rather than an exact measurement.
What the authors are calling for
Three things: rigorously evaluated prevention and response strategies; research that addresses the intersection of gender identity, race, age and socioeconomic status; and an effort to standardise how violence and gender identity are measured —for instance, using the two-step method recommended by international bodies— so that future maps are more comparable.
Source: Global Burden of Violence Against Transgender and Gender-Diverse Adults: A Systematic Review and Meta-Analysis. McLellan C, Yeh PT, Kennedy CE, Barré-Quick M, Rich AJ, Poteat T, Cooney EE. JAMA Network Open 2026;9(1):e2552953. DOI: 10.1001/jamanetworkopen.2025.52953.
Read the publication: JAMA Network Open.
Article published on dosier.es. Image generated with artificial intelligence (marta ai → marta.syf.es).
